Aa
Aa
A
A
A
Close
Avatar universal

Please Help me understand my Pet Scan Report, Thank You.

I had a major back surgery procedure and have been having chest pain and shortness of breath since the surgery. Here is the Pet Scan That I just had done yesterday;Please Help me understand my Pet Scan Report:
Findings:
PET:
There is homogenous, mildly increased FDG activity associated with an ill-defined anterior mediastinal soft tissue density. This finding in nonspecific and may be related to thymic tissue or rebound thymic hyperplasia. No discrete focal areas of intensely increased uptake within the thymus is identified. Minimal increased uptake is noted within the hilar areas bilaterally, right greater than left, in association with mildly prominent bilateral hilar lymph nodes. This finding is also nonspecific and may be reactive or malignant in etiology. Mild enlargement of the spleen is noted, with increased FDG activity compared with the liver. This finding is also nonspecific given the presenceof diffuse hepatic stestosis. Linear increased activity is noted in association with an anterior abdominal wall surgical scar. The remainder the body demonstrates physiologic uptake of radiopharmaceutical.
CT Scan:
There are postsurgical changes related to prior L5 left hemilaminectomy, S1 right hemilaminectomy, and L5-S1 fusion with an L5 right pedical screw, S1 left pedicle screw and interbody spacers at the L4-L5 and L5-S1 levels. A 5mm right lower lobe pulmonary nodule seen on series 3, image 66 is below the resolution of PET. There is diffuse hepatic steatosis, with an area of focal fatty sparing along the medial aspect of the gallbladder fossa. In addition, there is diffuse fatty atrophy of the pancreas.
IMPRESSION:
1. Mildly increased homogenous activity associated with an anterior mediastinal soft tissue density likely representing the thymus. This finding is nonspecific and may be related to persistent thymic tissue or thymic hyperplasia. Low-grade malignant involvement cannot be completely excluded. If clinically indicated, further evaluation with chest MRI to attempt to characterize the anterior mediastical soft tissue as thymic tissue can be performed. Alternatively, histologic sampling could be performed if there is a high clinical suspicion of malignancy.
2. Minimal increased FDG activity associated with mildly prominent bilateral hilar lymph nodes, right greater than left. These findings are also nonspecific and may be reactive or malignant etiology.
3. Increased FDG activity associated with an enlarged spleen is also nonspecific in the setting of diffuse hepatic steatosis.
4. 5mm right middle lobe pulmonary nodule unchanged compared with 06/23/2011 chest CT. If the patient has no risk factors for malignancy, a one year follow-up chest CT is recommended. If the patient has risk factors for malignancy, a chest CT in 6 to 12 months is recommended, with additional follow-up chest CT examinations thereafter to document 2 years of stability in the size and appearance of this nodule. At time of future imaging studies, the hilar lymph nodes and anterior mediastinal soft tissue can be re-evaluated.
8 Responses
Sort by: Helpful Oldest Newest
1081992 tn?1389903637
COMMUNITY LEADER
Hi, before anything else: did the chest pain and shortness of breath start after this PET/CT was done?

The first thing that comes to my mind with chest pain and shortness of breath after orthopedic surgery (including screws into bone) is the possibility of a PULMONARY EMBOLISM  (PE). Did you get anticoagulation drugs after discharge to prevent a PE?

If you have not told the surgeon about the chest pain and shortness of breath, you need to do that immediately - tell the answering service or whoever you can talk to --- or call the hospital.

Note that a PE is a MEDICAL EMERGENCY. A PE can be fatal. Maybe you don't have a PE but the combination of major surgery followed by chest pain and shortness of breath means you need to be checked out ASAP. Don't wait.

Once that's done I'll be happy to help you with understanding the PET and that anterior mediastinal tissue.
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
just keep calling everybody and be sure to say, "I've recently had major surgery and now have chest pain and shortness of breath, I might have a pulmonary embolism"

or maybe you should just go to the ER immediately

if your fatty liver (hepatic steatosis) is from being overweight, that's another risk factor for embolisms

if you've been sedentary recently, that's another risk factor

the biggest risk factor is from all the cutting and using of power tools in the surgery, that can create blood clots and a clot can travel to the lungs

it's not even unusual for a PE to be mistaken for a heart attack, especially in ERs

please post back on how this ends up, I hope you turn out okay and don't think I'm being unnecessarily alarmist - but people have let things go and regretted it

good luck

it seems (on rereading) that your chest pain and shortness of breath did begin before the PET/CT, but that's not the best for diagnosing a CT. They have to look for a PE specifically.
Helpful - 0
907672 tn?1381025723
Hi PlumberSR,
I agree with Ken, chest pain and shortness of breath after surgery can be serious.  It might be that you're just anemic from blood loss during surgery, but it could be a PE, which needs to be dealt with right away.  

Has your doctor talked to you at all about the PET scan?  I know it can be quite scary to read the scans, especially before the doctor has a chance to explain them to you.  

FDG activity/uptake.  What is it?  Well, FDG is that radioactive sugar they give you before a PET.  It is basically attracted to malignant cells in the body.  Unfortunately it can also send false positive results if you have other things going on like infection or increased muscle activity (that's why they have you sit very still before the PET).  

It looks like both the PET and CT scans confirm there is something going in the mediastinal area, specifically your thymus.  It basically says it could be a" reactive thymic hyperplasia", which is an enlarged thymus, or, possibly something malignant.  They are recommending a chest MRI or possibly a biopsy for confirmation if your doctor clinically believes it's warranted.  

I know it's incredibly difficult to not jump to conclusions and think you have cancer, but try not to worry until your doctor talks to you further.  This could be something reacting to the major surgery you just had.  These scans can pick up every little inconsistancy and radiologists have to cover themselves and address each one.  
    
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
but anemia does not explain pain - unless maybe there was CAD with stable angina exacerbated by anemia

I'd guess the scan was even perhaps done to investigate the chest pain and SOB - which didn't reveal a cause

anyway, not enough to go on unless PlumberSR writes back

Helpful - 0
Avatar universal
Yes the doctors were concerned about a PE and they tested me for PE. I don't hav a PE. They said that I am full of swollen Lympnodes in my chest area and my spleen is very enlarged. So they had me do more tests and these are the results that are most recent. I am going in for a Bone Marrow Biopsy tomorrow. Does any of my test results confirm that I have cancer any where?
With my heart,
They did a ECG, after my surgery when I went to the ER for chest pain and this is what the most recent ECG is saying:
*Nonspecific ST-T abnormalities, myocardial ischemia may be contributory
*Decreased anterior R waves may reflect anterior wall damage.
*ST segment elevation; distinction between myocardial injury and a normal variant requires     clinical correlation.
*Compared to 05/20/11 poor R wave progression is new.
***Abnormal ECG***

So what do you guys think this ECG is saying about my heart condition???
Helpful - 0
Avatar universal
So what do you guys think the ECG is saying about my heart?????

Yes the doctors were concerned about a PE and they tested me for PE. I don't hav a PE. They said that I am full of swollen Lympnodes in my chest area and my spleen is very enlarged. So they had me do more tests and these are the results that are most recent. I am going in for a Bone Marrow Biopsy tomorrow. Does any of my test results confirm that I have cancer any where?
With my heart,
They did a ECG, after my surgery when I went to the ER for chest pain and this is what the most recent ECG is saying:
*Nonspecific ST-T abnormalities, myocardial ischemia may be contributory
*Decreased anterior R waves may reflect anterior wall damage.
*ST segment elevation; distinction between myocardial injury and a normal variant requires     clinical correlation.
*Compared to 05/20/11 poor R wave progression is new.
***Abnormal ECG***

So what do you guys think this ECG is saying about my heart condition???
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
The short answer is that you are borderline on the tests for cancer and also on the heart test.

As Mocha had mentioned, cancer cells eat more of the radioactive sugar called FDG - because they are more active than normal cells and so they need more fuel. But immune cells also take up more of the radioactive sugar when they are fighting infection - because they are more active than usual, too.

So your report discusses whether your problem is due to cancer or to an immune reaction. You seem to be on the borderline. So to your question: "Does any of my test results confirm that I have cancer any where?" the answer is NO, not confirmed. There is only *suspicion* that centers around the thymus, which is a gland involved in immune reactions. It lies behind the breastbone. (It's involved with immune cells called T-lymphocytes.)

When they say "Low-grade malignant involvement cannot be completely excluded" that means that cancer is not the most likely suspect - and if it is cancer it would be slow growing aka 'low grade'.

So then why are you having a bone marrow biopsy tomorrow? I'd guess that your blood cell counts, as measured on the blood test called a CBC, were low. One possible reason they can be low is that cancer cells are crowding out the normal production of blood cells that occurs inside the marrow. So they drill in and take a core sample.

About your ECG: once again you are on the borderline. The key is "ST segment elevation" also called STEMI - which is usually the sign of damage from a heart attack. But yours look like it might just be a "normal variant" - your heart just beats that way. So the docs need other evidence as to whether you'd had a heart attack or not.

But it also says: "*Decreased anterior R waves may reflect anterior wall damage."

which means that another part of the ECG reveals that some heart muscle may have been damaged by lack of blood, which is 'ischemia' from a blocked heart artery.

I'd guess that if you did have a heart attack, it was relatively mild - so you're lucky in that. Or else you didn't have a heart attack.

Hope that helps, and good luck tomorrow. If it were me, I'd ask for a copy of the bone marrow biopsy report to be mailed to you - that way you don't have to wait for a doc appt to see what it means. We should be able to interpret it, if you like.
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
correction: STEMI = ST segment Elevation Myocardial Infarction

but it's not sure if you had a Myocardial (heart muscle) Infarction (damage from lack of blood flow)

Helpful - 0
Have an Answer?

You are reading content posted in the Leukemia and Lymphoma Community

Top Leukemia & Lymphoma Answerers
1081992 tn?1389903637
PA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
An interview with the co-discoverer of one of the biggest breakthroughs in cancer research
From causes to treatment options, get answers to your questions about CML, a type of blood cancer
New drug options on the horizon may make CML, a type of blood cancer, one of the few success stories in cancer treatment
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.